Participant Information Form

This form must be completed prior to March 30th to ensure you are able to register for classes April 22-24, 2019.Only continue with this form if your participant space for the 2019 Annual Leadership & Training Seminar has already been paid for by your organization and your organization has received confirmation from the AWAG Treasurer. If you want to confirm if you have been sponsored by an organization - please email Brietta Lowman at registration@awagleadership.org.

Thank you!

* Indicates required field

Name *

Contact Email *

Contact Phone Number *

Sponsoring Organization *

Please note which organization is paying your participant fees.

Emergency Contact Name *

Emergency Contact Phone (please include area code) *

I have requested and paid for a single supplement. *

YesNo

I am a *

FemaleMale

This question is for rooming purposes.

Please pick a roommate for me. *

YesNo

If No, Name of Requested Roommate *

I have a valid DOD ID card. *

If not, please email a copy of your passport to registration@awagleadership.org no later than April 5, 2017 to ensure access to Edelweiss Lodge and Resort during Seminar.

I am a prior AWAG Board of Governors member. *

I am currently serving as a *

I am / my spouse is currently serving as an O-5 or O-6 in command or their enlisted E-9 counterpart. *

Optional Demographic Questions:

I am a *

Age Range *

Military Branch *

How did you hear about us? *

I am replacing a participant from my organization that previously signed up. *

YesNo

If yes, please enter participant name here: *

Special/ Medical/ Dietary Needs *

Additional Comments *

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